Cryptosporidiosis in HIV-positive patients and related risk factors: A systematic review and meta-analysis

Ahmadpour, E. and Safarpour, H. and Xiao, L. and Zarean, M. and Hatam-Nahavandi, K. and Barac, A. and Picot, S. and Rahimi, M. T. and Rubino, S. and Mahami-Oskouei, M. and Spotin, A. and Nami, S. and Baghi, H. B.

Parasite (2020) 27: 27

DOI: 10.1051/parasite/2020025

Abstract

Cryptosporidium is one of the major causes of diarrhea in HIV-positive patients. The aim of this study is to systematically review and meta-analyze the prevalence of Cryptosporidium in these patients. PubMed, Science Direct, Google Scholar, Web of Science, Cochrane and Ovid databases were searched for relevant studies dating from the period of 1 January 2000 to 31 December 2017. Data extraction for the included studies was performed independently by two authors. The overall pooled prevalence was calculated and subgroup analysis was performed on diagnostic methods, geographical distribution and study population. Meta-regression was performed on the year of publication, proportion of patients with diarrhea, and proportion of patients with CD4 \textless 200 cells/mL. One hundred and sixty-one studies and 51,123 HIV-positive participants were included. The overall pooled prevalence of Cryptosporidium infection in HIV-positive patients was 11.2% (CI95%: 9.4%-13.0%). The pooled prevalence was estimated to be 10.0% (CI95%: 8.4%-11.8%) using staining methods, 13.5% (CI95%: 8.9%-19.8%) using molecular methods, and 26.3% (CI95%: 15.0%-42.0%) using antigen detection methods. The prevalence of Cryptosporidium in HIV patients was significantly associated with the country of study. Also, there were statistical differences between the diarrhea, CD4 \textless 200 cells/mL, and antiretroviral therapy risk factors with Cryptosporidiosis. Thus, Cryptosporidium is a common infection in HIV-positive patients, and safe water and hand-hygiene should be implemented to prevent cryptosporidiosis occurrence in these patients.

Citation

Ahmadpour, E., Safarpour, H., Xiao, L., Zarean, M., Hatam-Nahavandi, K., Barac, A., Picot, S., Rahimi, M. T., Rubino, S., Mahami-Oskouei, M., Spotin, A., Nami, S., & Baghi, H. B. (2020). Cryptosporidiosis in HIV-positive patients and related risk factors: A systematic review and meta-analysis. Parasite, 27, 27. https://doi.org/10.1051/parasite/2020025 Humans, Risk Factors, Geography, Prevalence, Diarrhea/parasitology, Feces/parasitology, Systematic review, CD4 Lymphocyte Count, Cryptosporidiosis/epidemiology/*parasitology/prevention & control, Cryptosporidium infection, HIV Infections/*complications/drug therapy/*parasitology, Aids, Hiv

Keywords

• Humans
• Risk Factors
• Geography
• Prevalence
• Diarrhea/parasitology
• Feces/parasitology
• Systematic review
• CD4 Lymphocyte Count
• Cryptosporidiosis/epidemiology/*parasitology/prevention & control
• Cryptosporidium infection
• HIV Infections/*complications/drug therapy/*parasitology
• Aids
• Hiv